The Prognostic Effect of Circadian Blood Pressure Pattern on Long-Term Cardiovascular Outcome is Independent of Left Ventricular Remodeling

We aimed to investigate the predictive value of 24 h blood pressure (BP) patterns on adverse cardiovascular (CV) outcome in the initially untreated hypertensive patients during long-term follow-up. This study included 533 initially untreated hypertensive patients who were involved in this study in the period between 2007 and 2012. All participants underwent laboratory analysis, 24 h BP monitoring, and echocardiographic examination at baseline. The patients were followed for a median period of nine years. The adverse outcome was defined as the hospitalization due to CV events (atrial fibrillation, myocardial infarction, myocardial revascularization, heart failure, stroke, or CV death). During the nine-year follow-up period, adverse CV events occurred in 85 hypertensive patients. Nighttime SBP, non-dipping BP pattern, LV hypertrophy (LVH), left atrial enlargement (LAE), and LV diastolic dysfunction (LV DD) were risk factors for occurrence of CV events. However, nighttime SBP, non-dipping BP pattern, LVH, and LV DD were the only independent predictors of CV events. When all four BP pattern were included in the model, non-dipping and reverse dipping BP patterns were associated with CV events, but only reverse-dipping BP pattern was independent predictor of CV events. The current study showed that reverse-dipping BP pattern was predictor of adverse CV events independently of nighttime SBP and LV remodeling during long-term follow-up. The assessment of BP patterns has very important role in the long-time prediction in hypertensive population

Chemical composition and antimicrobial activity of the essential oil from Satureja horvatii Šilić (Lamiaceae)

The present paper describes the chemical composition and antimicrobial activity of the essential oil of the endemic species Satureja horvatii Šilić, collected in Montenegro. The essential oil was obtained from the aerial parts of the plant by hydrodistillation and analyzed by GC–MS. From the 34 compounds representing 100 % of the oil, the major compound was the phenolic monoterpene thymol (63.37 %). The oil contained smaller amounts of g-terpinene (7.49 %), carvacrol methyl ether (4.92 %), carvacrol (4.67 %), p-cymene (4.52%), a-terpinene (1.81 %), borneol (1.58 %), a-thujene (1.56 %), b-caryophyllene (1.55 %) and b-myrcene (1.44 %). The antimicrobial activity of the essential oil of S. horvatii was evaluated using the agar diffusion and broth microdilution methods. The essential oil exhibited antimicrobial activity to varying degrees against all the tested strains. The maximum activity of S. horvatii oil was observed against Gram-positive bacteria (Micrococcus luteus, Staphylococcus epidermidis, Staphylococcus aureus and Enterococcus faecalis) and against the yeast (Candida albicans). The oil exhibited moderate activity against the Gram-negative bacteria Escherichia coli and Klebsiella pneumoniae and weak activity against Pseudomonas aeruginosa. This study confirms that the essential oil of S. horvatii possesses antimicrobial activities in vitro against medically important pathogens

Is There Any Point in a Corticosteroid Treatment of Intermittent Asthma?

International guidelines advocate the early introduction of inhaled corticosteroids (ICS) in all types of persistent asthma. Our study was undertaken to assess the effects of ICS on bronchial hyperresponsiveness (BHR) as a hallmark of inflammation, and to assess the symptoms, the use of rescue medications, and the parameters of lung function in patients with mild intermittent asthma. The patients with intermittent asthma (n = 85) were randomly allocated to a treatment with ICS, beclomethasone dipropionate 250 μg/day and short-acting β2 agonists salbutamol as needed (Group A, n = 45) or to a treatment with only short-acting β2 agonists as needed (Group B, n = 40) during the 6-month treatment period. At the end of the study, in Group A, we found a statistically significant decrease of BHR (PD20 0.98 vs. 2.07) (p < 0.001), diurnal peak expiratory flow (PEF) variability (17.9 vs. 13.8) (p < 0.001), symptom scores (0.63 vs. 0.30) (p < 0.001), and used rescue medication (p < 0.001), while the parameters of lung function remained unchanged except for forced expiratory volume in 1 sec (FEV1), which had a statistically significant increase (3.58 vs. 3.66) (p < 0.001). In Group B, there was a statistically significant decrease of lung function parameters FEV1 (3.80 vs. 3.71) (p < 0.001), forced vital capacity (FVC) (4.43 vs. 4.37) (p < 0.001), FEV1/FVC (88.2 vs. 85.3) (p < 0.05), PEF (8.05 vs. 7.51) (p < 0.01), PEF variability (17.85 vs. 18.33) (p < 0.001), increased BHR (PD20 1.04 vs. 0.62) (p < 0.05), and symptom scores (0.46 vs. 0.62) (p < 0.01), as well as the use of rescue medication during the day (p < 0.001). Early introduction of low doses of ICS may be more beneficial than β2 agonists alone in patients with intermittent asthma

Immune Cell Composition in Human Non-small Cell Lung Cancer

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the world. Immunological analysis of the tumor microenvironment (immunoscore) shows great promise for improved prognosis and prediction of response to immunotherapy. However, the exact immune cell composition in NSCLC remains unclear. Here, we used flow cytometry to characterize the immune infiltrate in NSCLC tumors, non-cancerous lung tissue, regional lymph node, and blood. The cellular identity of &gt;95% of all CD45+ immune cells was determined. Thirteen distinct immune cell types were identified in NSCLC tumors. T cells dominated the lung cancer landscape (on average 47% of all CD45+ immune cells). CD4+ T cells were the most abundant T cell population (26%), closely followed by CD8+ T cells (22%). Double negative CD4−CD8− T cells represented a small fraction (1.4%). CD19+ B cells were the second most common immune cell type in NSCLC tumors (16%), and four different B cell sub-populations were identified. Macrophages and natural killer (NK) cells composed 4.7 and 4.5% of the immune cell infiltrate, respectively. Three types of dendritic cells (DCs) were identified (plasmacytoid DCs, CD1c+ DCs, and CD141+ DCs) which together represented 2.1% of all immune cells. Among granulocytes, neutrophils were frequent (8.6%) with a high patient-to-patient variability, while mast cells (1.4%), basophils (0.4%), and eosinophils (0.3%) were less common. Across the cohort of patients, only B cells showed a significantly higher representation in NSCLC tumors compared to the distal lung. In contrast, the percentages of macrophages and NK cells were lower in tumors than in non-cancerous lung tissue. Furthermore, the fraction of macrophages with high HLA-DR expression levels was higher in NSCLC tumors relative to distal lung tissue. To make the method readily accessible, antibody panels and flow cytometry gating strategy used to identify the various immune cells are described in detail. This work should represent a useful resource for the immunomonitoring of patients with NSCLC

Characterization of immune cells in non-small cell lung cancer

Lung cancer is the fourth most prevalent cancer in Norway, holding first place in mortality rate. Non-Small Cell Lung Cancer (NSCLC) is the most frequent type, representing about 85% of all lung cancer patients. Presently, the TNM staging, which is based on tumor size and localization, is used for diagnosis and prognosis in NSCLC. However, previous reports suggest that the analysis of tumor-infiltrating immune cells may represent a more accurate prognostic tool. The aim of this project was to perform comprehensive analysis of tumor-infiltrating immune cells in NSCLC using flow cytometry, as a first step to understanding the relationship between tumor-infiltrating immune cells and clinicopathological parameters. We used 10 colour flow cytometry to investigate immune cells in tumors, distant lung tissue, lymph node and peripheral blood, from 67 patients with primary NSCLC. The following populations of tumor-infiltrating immune cells were identified: CD4+ T cells, CD8+ T cells, each with memory and naive phenotypes; CD19+ B cells, with naive, memory, germinal center and plasma cell subsets; CD14+ macrophages, CD123+ plasmacytoid dendritic cells (pDCs), CD11c+CD1c+ dendritic cells (DCs), and CD11c+CD141+ DCs, CD3+CD56+ natural killer T cells (NKT), CD56+ natural killer (NK) cells, with CD16+ and CD16- subset, and four granulocyte population: eosinophils, basophils, neutrophils and mast cells. Statistical analysis revealed increased percentage of leukocytes within tumors compared to distant lung tissue. In the leukocyte population CD19+ B cells showed increase in tumor compared to the distant lung (p= 0.0001). This suggests that tumor microenvironment of NSCLC recruits immune cells and has different immunological structure compared to lung tissue.M-BIOTE

IMPORTANCE OF HEMOCULTURE IN DIAGNOSIS OF BACTEREMIA AND SEPSIS

Almost all kinds of microorganisms from blood can be isolated by hemoculture. The isolate consists of 75–85% Gram negative and Gram positive bacteria, until the other part of the isolate consists of fungi or other microorganisms.During the three-year period (1998–2001) we analyzed microbiological characteristics of all positive hemocultures inspected in microbiological laboratory in the Public Health Institute in Nis as well as clinical parameters of patients with the aim of determining the cause of bacteremia. We applied standard microbiologic methods for inspection of 1995 hemocultures taken from 759 patients whereupon we registered positive medical findings in 18,75%. In the majority of cases only one kind of microorganisms was isolated, while in 1.06% of positive hemocultures we isoleted two kinds of microorganisms.Isolation of Streptococcus b heamolyticus gr. A, Streptococcus pneumoniae, E.coli, Proteus mirabilisa, Salmonellae enteritidis, Pseudomonas aeruginose i Candide spp confirms bacteremia. Difteroids and Bacillus spp. were isolated only from contaminated hemocultures. Staphylococcus epidermidis is the most frequent contminant and causes bacteremia in the patients with intravascular catheter and patients on intravenous and peritoneal dialysis. A similar finding of α hemolitic streptococcus of viridans group was registered in the patients with subacute and acute endocarditis who had had an intravenous catheter implanted.On the basis of the results obtained, we can conclude that microorganisms from groups of Streptococcus, Staphylococcus, Candida and Enterobacteriaceace family are the most frequent causes of bacteremia. Beside its limiting factors (time of sampling, duration of incubation, possible contamination of samples, number of hemocultures), hemoculture is the only method by which the causes of bacteremia and sepsis can be isolated

Polymorphisms of Beta2-Adrenergic Receptor Gene in Serbian Asthmatic Adults: Effects on Response to Beta-Agonists

Background and Objectives Polymorphisms of beta2-adrenergic receptor gene (ADRB2) are clinically relevant for several reasons, including as a risk factor for asthma development/severity and predicting the effectiveness of treatment with beta2-agonists in reducing asthma symptoms. The aim of this study was to examine the association between ADRB2 gene polymorphisms and asthma in the Serbian population, and to evaluate the therapeutic response in relation to the ADRB2 genotype. Methods The study included 171 patients with asthma and 101 healthy subjects as the control group. Genotyping of Arg16Gly and Gln27Glu polymorphisms was performed by direct sequencing of polymerase chain reaction (PCR) products. Results In Serbian adults, carriers of the 27Gln allele and 27Gln/Gln genotype were at higher risk of asthma [odds ratio (OR) 2.5, 95 % confidence interval (CI) 1.6-3.8, and OR 3.00, 95 % CI 1.7-5.3, respectively], while the presence of the 27Glu allele and 27Gln/Glu genotype were found to be protective of asthma (OR 0.4, 95 % CI 0.3-0.6, and OR 0.3, 95 % CI 0.1-0.7, respectively). Furthermore, we found that the presence of the 27Gln allele in asthmatics younger than 50 years leads to a better response to therapy with long-acting beta2-agonists (LABA) in combination with prevailing low and moderate doses of inhaled corticosteroids (ICS), while carriers of the 27Glu allele over 50 years old are more likely to respond to LABA + ICS therapy. Conclusion We identified that in Serbian adults the 27Gln allele and 27Gln homozygosity are risk factors for asthma, which may be of clinical interest in disease prevention. The finding that younger carriers of the 27Gln allele respond better to LABA + ICS therapy may be utilized in personalized asthma treatment

The Prognostic Effect of Circadian Blood Pressure Pattern on Long-Term Cardiovascular Outcome Is Independent of Left Ventricular Remodeling

We aimed to investigate the predictive value of 24 h blood pressure (BP) patterns on adverse cardiovascular (CV) outcome in the initially untreated hypertensive patients during long-term follow-up. This study included 533 initially untreated hypertensive patients who were involved in this study in the period between 2007 and 2012. All participants underwent laboratory analysis, 24 h BP monitoring, and echocardiographic examination at baseline. The patients were followed for a median period of nine years. The adverse outcome was defined as the hospitalization due to CV events (atrial fibrillation, myocardial infarction, myocardial revascularization, heart failure, stroke, or CV death). During the nine-year follow-up period, adverse CV events occurred in 85 hypertensive patients. Nighttime SBP, non-dipping BP pattern, LV hypertrophy (LVH), left atrial enlargement (LAE), and LV diastolic dysfunction (LV DD) were risk factors for occurrence of CV events. However, nighttime SBP, non-dipping BP pattern, LVH, and LV DD were the only independent predictors of CV events. When all four BP pattern were included in the model, non-dipping and reverse dipping BP patterns were associated with CV events, but only reverse-dipping BP pattern was independent predictor of CV events. The current study showed that reverse-dipping BP pattern was predictor of adverse CV events independently of nighttime SBP and LV remodeling during long-term follow-up. The assessment of BP patterns has very important role in the long-time prediction in hypertensive population